The Influence Of Blood Pressure Control On Expansion Of Heamatoma In Patients With Hypertensive Cerebral Hemorrhage

Subject: To discuss the influence of blood pressure control on the expansion of heamatomas in patients with hypertensive cerebral hemorrhage during acute stage.Methods: A series of 68 patients who were in accordance with the inclusion criteria was analyzed. The sex, age and past history of the patients, the bleeding site, the blood pressure were all recorded. All patients underwent first CT immediately on admission, second CT were underwent immediately when the patients'neurological function deteriorated progressively, or second CT were underwent at 24 hours after ictus if patients'clinical symptom were stable. Hematoma volume in the first CT(V1) and the second CT(V2) were measured. The longest diameter(A) of the hematoma and the second diameter(B) on the perpendicular line were measured in the slice with the largest area of ICH. The height of the hematoma was calculated by multiplying the number of slices involved by slice thickness, providing the third diameter(C). The 3 diameters were multiplied and then divided by 2(A×B×C/2)to obtain the volume of ICH. Growth of hematoma was defined as an increasein the volume of V2-V1≥33%V1. The patient can be diagnosed hematoma enlargement. According to the Systolic Blood Pressure, the patients were divided into three groups; group I: 140mmHg≤SBP≤159mmHg;groupⅡ:160mmHg≤SBP≤179 mmHg;groupⅢ: SBP≥180mmHg. According to the regulation of the Systolic Blood Pressure, the patients were divided into two groups; group A: SBP<160mmHg, group B:SBP≥160mmHg. Discuss the relationships between the blood pressure regulation and hematoma enlargement during acute stage of hypertensive cerebral hemorrhage. The results was analyzed by SPSS(version 13.0). Measurement data and numeration data were compared with t test andχ2 test, respectively, and P<0.05 was considered to be statistically significant.Results: The patients'blood pressure is higher, especially within 6 hours. The short time occurrence is the factor of the earlier extension of haematomas. The ratio of extention is 46.7% within 6 hours, the ratio of extention is 35.0% during 6-12 hours, the ratio of extention is 20.0% during 12-24 hours, the ratio of extention is 12.5% after 24 hours. 3 of 16 patients in I group(140mmHg≤SBP≤159mmHg), blood tumor extended. The ratio of extention is 18.75%. 13 of 40 patients in II group(160mmHg≤SBP≤179mmHg), blood tumor extended. The ratio of extention is 32.50%. 8 of 12 patients in III group(SBP≥180mmHg), blood tumor extended. The ratio of extention is 66.70%. Compaired the ratio of extention of the three group with theχ2 test, the different is significantly. (P<0.05). The relationship of regulation of blood pressure and blood tumor enlargement: group A (SBP<160mmHg), the ratio of extention is 18.75%; group B(SBP≥160mmHg)the ratio of extention is 75.00% . Compaired the ratio of extention of the three group with theχ2 test the different is significantly.Conclusion: 1. High SBP is one independent risk factors of the blood tumor extention. 2. The short time occurrence is the factor of the earlier extension of haematomas. The haematomas is more englarged especially with 6 hours. 3. The patients whose SBP is higher than 180mmHg is easily have the blood tumor extended, So is the patients whose SBP can not be effectively controlled. The patients whose SBP is lower than 160mmHg is rare have the blood tumor extended. 4.The control of the blood pressure has close relationship with the extention of the blood tumor.